Table 1.

Summary of selected studies evaluating the use of noninvasive ventilation and high-flow nasal cannulae therapy in paediatric emergency rooms and general wards21–24,28,29

Author and year of study	Study design	Mode of respiratory support	Study setting	Sample	Outcome
Franklin et al.24 (2018)	RCT	Low-flow oxygen versus HFNCT	Paediatric ERs and general wards at 17 hospitals	1,472 infants aged <12 months with bronchiolitis	Fewer infants in the HFNCT group required transfer to the PICU compared to those in the low-flow oxygen group (12% versus 23%). Overall, 61% of infants in the low-flow oxygen group required rescue treatments involving HFNCT.
Davison et al.21 (2017)	Retrospective study	HFNCT	Non-tertiary ER and paediatric wards	61 infants and children aged 1–23 months with suspected bronchiolitis	Two-thirds of the patients underwent HFNCT in paediatric wards with no adverse effects. Only 13% of patients required transfer to an off-site PICU.
Ballestero et al.22 (2018)	Prospective randomised pilot study	Low-flow oxygen versus HFNCT	Tertiary paediatric ER	62 children aged 1–14 years with refractory asthma and respiratory failure	HFNCT was superior to low-flow oxygen in improving respiratory distress within two hours of treatment.
Vitaliti et al.23 (2013)	Retrospective study	NIV	Paediatric ER	Children presenting with respiratory distress	NIV led to improvements in WOB and pulmonary gas exchange. In addition, NIV reduced the need for PICU transfer.
Kelly et al.28 (2013)	Retrospective study	HFNCT	ER	498 children with bronchiolitis, pneumonia or asthma	The majority of patients were treated successfully with HFNCT, with only 8% requiring intubation. Most cases of HFNCT failure demonstrated features of impending respiratory failure at triage stage.
Long et al.29 (2016)	Prospective observational study	HFNCT	ER	71 patients	The majority of patients improved following HFNCT, with only 39% requiring escalation of respiratory support.

RCT = randomised controlled trial; HFNCT = high-flow nasal cannulae therapy; ER = emergency room; PICU = paediatric intensive care unit; NIV = noninvasive ventilation; WOB = work of breathing.